文章基本信息

标题：Onset of Natural Menopause in African American Women
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作者：Julie R. Palmer ; Lynn Rosenberg ; Lauren A. Wise 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2003
卷号：93
期号：2
页码：299-306
语种：English
出版社：American Public Health Association
摘要：Objectives . This study assessed predictors of the onset of natural menopause in African American women. Methods . We used mailed questionnaires to collect data at baseline in 1995 and during follow-up from Black Women’s Health Study participants. Cox proportional hazards regression was used to assess potential predictors—including experiences of racism—of the onset of natural menopause among 17 070 women aged 35 to 55 years and premenopausal in 1995. Results . The hazard ratio (HR) was 1.43 for current smokers (95% confidence interval [CI] = 1.24, 1.66) and 1.21 (95% CI = 1.06, 1.38) for ex-smokers and significantly less for obese women and oral contraceptive users. Hazard ratios for most questions about racism were elevated by 10% to 30% but were not statistically significant. Conclusions .Earlier onset of natural menopause among African American women is strongly associated with smoking and inversely associated with body mass index and oral contraceptive use. A woman’s age at the onset of natural menopause is associated with several serious illnesses. For example, early menopause has been associated with an increased risk of osteoporosis 1, 2 and with an increased overall mortality. 3, 4 Cigarette smoking is the only factor that has been consistently linked to earlier natural menopause. 5– 13 Nulliparity, 12, 14– 16 nonuse of oral contraceptives, 12, 16– 18 low body mass index, 10, 19 and low educational status 12, 16, 20 have also been associated with earlier menopause, but the evidence is inconsistent. Almost all available data on determinants of age at natural menopause in American women have come from studies of White women. The exceptions are Bromberger et al.’s 6 prospective study of age at natural menopause, which included 19 Black women and Gold et al.’s 12 cross-sectional study of natural menopause, which included 4157 African American women. One of the findings of the Bromberger study was an association between increased stress and an earlier age of menopause among the Black women. In our report, we prospectively assessed the relation of demographic, reproductive, and health factors to age at natural menopause among US Black women, based on data from a follow-up study of 64 500 African American women. To pursue a hypothesis raised by the study of Bromberger et al., 6 we also assessed the relation of participants’ perceived experiences of racism to the risk of early menopause.